Bill Of Sale - Affidavit To A Fact Form - Kansas Department Of Revenue Page 3
ADVERTISEMENT
1
2
3U.S. military. Person signing must follow the
order listed. KSA 8-129)
I, the undersigned, certify that I
am the (Must Check One):
Spouse;
Parent;
Eldest Brother or Sister
of
, a member of (branch of
service)
.
ANTIQUE MODEL YEAR
LICENSE PLATE (
Used when
registering an antique vehicle with a model
year Kansas license plate.)
Lic
Year on
Plate Number
en
Plate
All
Letter
se
s and
Numb
Pl
ers
Must
at
be
e
Show
n
Inf
or
m
ati
on
:
I, the undersigned, certify that the
license plate listed above is a
legible and serviceable license
plate, originally issued by the state
of
Kansas and the expiration year
inscribed thereon corresponds to the
model year when the antique
vehicle was manufactured.
A
’
FFIANT
S
C
ERTIFICATION
I certify under penalty of perjury
that all information and statement(s)
made above are true to the best of
my knowledge.
Affiant’s Signature(s)
Printed Name of Person(s)
that Signed Above
Date
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form K-wc 96 - Registration For Access To Electronic Records Form - Kansas Department Of Labor
Legal
Form Mvu-33 - Affidavit In Support Of A Claim For Exemption From Sales Or Use Tax For A Motor Vehicle Transferred To A Disabled Person - Massachusetts Department Of Revenue
Financial
Form K-wc 105 - Employer's Application Oath To Become A Self-insurer Form - Kansas Department Of Labor
Legal
Form St-28ee - Clean Drinking Water Fee Exemption Certificate Form - Kansas Department Of Revenue
Financial
Related Categories
Parent category: Financial